The role of psychiatric factors in symptoms of hiatus hernia or gastric reflux.

Abstract

The study comprised 26 patients with somatic symptoms indicating a hernia-reflux syndrome referred to a university hospital ear, nose and throat department. The aim was to throw light on the hypothesis that this syndrome is largely a psychosomatic problem. The patients were divided into two groups: subjects with and without laboratory findings of physical pathology of hernia and/or reflux. Intergroup comparisons were made of symptoms, a psychological test and psychiatric ratings. Those who had no laboratory findings of physical pathology often reported "phobia" and "feeling of lump in the throat", which were interpreted as signs of hysterical or somatizing mechanisms. Most of these patients showed a high level of anxiety in the psychological test. "Agitation", "depression" and "frustration" were characteristics of patients with laboratory findings of reflux. "Depression" was interpreted as a reaction to the somatic illness. The group with reflux contained more old male patients and that without more younger female patients.